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The Berwick Review is just the latest in a series of reports on the NHS

NHS reviews are getting a bit like buses. Miss one and you don't need to wait long for another to come round the corner.

A month ago there was the Cavendish Review into healthcare assistants, and then two weeks later the Keogh Review into mortality rates, which led to 11 trusts being put into special measures, was published.

All three were commissioned off the back of the Francis Inquiry into the Stafford Hospital scandal.

Once again, it has been met with the usual platitudes.

But there is also a sense that the time for talking is coming to an end: action is what is needed.

Responding to publication of the 45-page safety review, the Unison healthcare union said there was "no time to waste".

Meanwhile, the choice and empowerment organisation Patient Concern dismissed Prof Berwick's report as "long on what is needed but short on how its recommendations will be made to happen".

That may seem a little harsh. After all, Prof Berwick is perhaps the world's leading expert on patient safety.

Continuing confusion

But Patient Concern's exasperation is perhaps a sign that greater clarity is needed.

The Francis Inquiry made 290 recommendations. The three follow-up reports have brought that number to almost 500 and there is still a fourth, on complaints handling, to come.

And yet there is still confusion over what the government is doing on issues such as minimum staffing, criminalising neglect, improving nurse training and introducing a robust system of oversight for healthcare assistants.

It is true that there have been some changes. A chief inspector of hospitals has been appointed and a new inspection regime starts next month.

But after the flurry of reports and recommendations of recent months, the NHS will be after some clear direction from ministers once their holidays are over and Parliament resumes in September.